If you think feeding assistants have generated controversy in long-term care, witness the fast-growing debate over "medication technicians"--CNAs trained to administer medication. In Arizona, the governor recently signed a bill authorizing a two-year pilot study using CNAs trained as medication technicians in SNFs' nonskilled, or "custodial," units. To be considered medication technicians, CNAs would be required to pass a competency evaluation and would be able to dispense medication only when a licensed nurse is on the unit.

Nursing organizations are at loggerheads over this. The Arizona Nurses Association (AzNA) supports the project on grounds that using medication technicians would allow licensed nurses to focus on crucial care tasks rather than routine medication administration, according to AzNA President Kathy Player, EdD, RN. Although AzNA notes that nine states already are using medication technicians and claiming success, the organization will wait until the study is completed before deciding whether to formally endorse their use for custodial SNF patients in stable condition. It has no plans to endorse their use in subacute or acute care areas.

On the other hand, the Southern Arizona Nurses Coalition (SAZNC-CNA, affiliated with the California Nurses Association) opposes the pilot study. SAZNC-CNA fears that using medication technicians could overburden RNs and LPNs with supervisory responsibilities or leave the technicians without adequate supervision. The organization also is concerned that legalization of medication technicians in SNFs could lead to their use in other settings, including hospitals.

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